eng Science and Education Publishing American Journal of Nursing Research 2378-5586 2025-12-25 13 4 123 131 10.12691/ajnr-13-4-6 AJNR20251346 article Fatimah Alyousef fmalyousef@moh.gov.sa 1 Zainab Alswaid 1 Eman Alshikh 1 Sameerah Alkhabbaz 1 Amal Almalali 1 Amal Mohamed 1 Reem Almoslem 1 Ebtihal Alfardan 1 Anak General Hospital, Eastern Health Cluster, Ministry of Health, Saudi Arabia This study investigates the impact of nurse leadership styles on nursing staff performance in both rural healthcare divisions and the Qatif Health Network under the Eastern Health Cluster in Saudi Arabia. A cross-sectional design was used, employing the Multifactor Leadership Questionnaire (MLQ-5X) to measure transformational, transactional, and laissez-faire leadership styles. Data from 380 nurses were analyzed using descriptive statistics, Pearson correlations, and multiple regression analyses. Results revealed that transformational and transactional leadership styles had strong positive correlations with job satisfaction, while laissez-faire leadership showed no significant effect. No statistically significant difference was found between rural and urban settings, suggesting that effective leadership practices transcend environmental differences. The findings underscore the importance of developing transformational and transactional leadership skills to improve nurse satisfaction, retention, and performance, aligning with Saudi Arabia¡¯s Vision 2030 goals for healthcare excellence. https://pubs.sciepub.com/ajnr/13/4/6/ajnr-13-4-6.pdf Transformational leadership transactional leadership laissez-faire leadership nursing performance job satisfaction rural healthcare Qatif Health Network Eastern Health Cluster Saudi Arabia Vision 2030